Form Attachment H Attachment H Business Classification REport

Cognitive and Psychological Research

FGP Screening Form2

FGP Westat - Mail Update

OMB: 1220-0141

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Bureau of Labor Statistics

U.S. Department of Labor

O.M.B. No. 1220-0141

Expires April 30, 2018

Business Classification Report


Shape5 Please complete and return this form by MMMM DD, YYYY.

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1

What is your contact information?

Please provide contact information for the person who completed this form.

Name:


Title:


Business website:


Phone:

( )





E-mail:


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2


If the address below is not correct, please enter the updated address in the space provided.



Enter Address Corrections for Physical Location Below

[FILL COMPANY NAME]



[FILL ADDRESS 1]



[FILL ADDRESS 2]



[CITY, STATE,ZIP]



[RUN_DESC]





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3


Does the worksite listed in Question 2:

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a

Manufacture any products or produce any goods?

  • Yes

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    b

    No

Arrange for any products or goods to be manufactured outside the U.S.?

  • Yes

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    c

    No

Arrange for any products or goods to be manufactured inside the U.S. by an independent manufacturer?

  • Yes

  • No

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4


If you have any comments about this report, please note them here:






Thank you for completing this report. Please return it using the self-addressed, stamped envelope.


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File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
AuthorMockovak, William - BLS
File Modified0000-00-00
File Created2021-01-23

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